Open versus Arthroscopic in Management of Tennis Elbow. A Systematic Review

Abstract

Background Treatment of resistant tennis elbow (lateral epicondylitis) still challenging, which may require surgery in order to gain pain relief and improve function. Aim of the Work The aim of this study is to systematic review and meta-analysis arthroscopic to open surgery for resistant TE regarding ROM, grip strength, DASH score, VAS, and complications. Methodology This study was approved by the Ethics Committee of Ain Shams University Faculty of Medicine. Written informed consent was not needed because of the study design (systematic review). We included randomized control trails (RCTs), controlled clinical trials, retrospective cohort studies, case series studies and we excluded case reports, cross sectional studies, non English study. Search results will be conducted to systematic review management software and manually screened for eligibility to be included. PRISMA flowchart will be produced based on the search results and the inclusion/exclusion criteria. Results Our systematic review found that the most relevant conclusion from the current study is that there is a significant difference between the 2 operative techniques when examining VAS score, Mayo elbow performance score, grip strength, DASH score and time to return to work in favor of arthroscopic technique. While the arthroscopic surgery had a longer surgical time than the open technique. Additionally, it was found that the complication rates, DASH score, range of motion and failure rates were similar between the arthroscopic and the open technique. Conclusion We found a similar effectiveness of both arthroscopic and open techniques in improving failure risk, complication rate and range of motion postoperative in the treatment of tennis elbow. There is significant difference between arthroscopic and open surgery with regards to self-reported function (DASH), pain intensity (VAS) at follow up, time to return to work and grip strength postoperative in favor of arthroscopic technique. The current meta-analysis found that arthroscopic surgery had a longer surgical time than the open surgery for lateral epicondylitis.